Individual provider Active NPI

Lizette Lizcano Martinez, M.S. CCC/SLP

  • Speech-Language Pathologist
  • Pharr, TX
National Provider Identifier
1790455772
Registry record updated Sep 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
109568 Issued in TX
Practice address
615 W Eldora Rd
Pharr, TX 78577-8073
Phone
(956) 354-2710
NPI assigned
Sep 20, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 20, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 109568 TX Primary

Addresses

Primary practice location

615 W Eldora Rd
Pharr, TX 78577-8073

Mailing address

2014 Fair Oaks Dr
Mission, TX 78574-2000
Phone (956) 249-0007

Other names 1

  • Ms. Lizette Martinez Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
109568TXMDSpeech-Language Pathologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1632096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632096000000",
    "number": "1790455772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2014 FAIR OAKS DR",
            "city": "MISSION",
            "state": "TX",
            "postal_code": "785742000",
            "telephone_number": "956-249-0007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 W ELDORA RD",
            "city": "PHARR",
            "state": "TX",
            "postal_code": "785778073",
            "telephone_number": "956-354-2710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "LIZETTE",
        "middle_name": "LIZCANO",
        "credential": "M.S. CCC/SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-20",
        "last_updated": "2021-09-20",
        "certification_date": "2021-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "109568",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LIZETTE",
            "last_name": "MARTINEZ",
            "prefix": "MS.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Pharr, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.